动脉化静脉皮瓣与岛状皮瓣修复治疗手外伤指端软组织缺损的疗效
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摘要
目的比较观察手部开放性创伤所致指端部分软组织缺损患者采用动脉化静脉皮瓣与岛状皮瓣修复治疗的愈后疗效。方法选我院2016年11月-2018年11月期间收治的手部开放性创伤至指端软组织缺失患者88例为此次研究目标,利用随机抽签法将患者分为治疗组与对照组。对照组患者采用指固有岛状皮瓣修复,治疗组采用微型动脉化静脉皮瓣修复,对比二者治疗总有效率,讨论二者并发症发生率差异。结果两组皮瓣均成活,实验组并发症发生率9.09%,术后随访关节活动优良率88.64%,伤指感觉恢复优良率93.18%,皮肤颜色优良率97.37%,患者治疗满意度95.45%,各项指标均优于对照组,差异有统计学意义(P <0.05)。结论动脉化静脉皮瓣修复治疗手外伤指端软组织缺损美观度高、指功能恢复好,效果优于岛状皮瓣,更具临床推广价值。
Objective To compare the curative effect of arterialized venous flaps and island skin flaps in repairing soft tissue defect of fingertip caused by open hand trauma. Methods 88 patients with open hand trauma to fingertip soft tissue deficiency admitted to our hospital from November 2016 to November 2018 were selected as the objective of this study. The patients were divided into treatment group and control group by random lottery. Patients in the control group were repaired with finger island skin flaps, while those in the treatment group were repaired with miniature arterialized venous flaps. Discuss the difference in the incidence of complications between the two groups. Results The flaps survived in both groups. The complication rate in the experimental group was 9.09%. The excellent rate of joint movement was 88.64%. The excellent rate of sensory recovery of injured fingers was 93.18%. The excellent rate of skin color was 97.37%. The patients' satisfaction with treatment was 95.45%. The indexes were better than those in the control group. The difference was statistically significant(P < 0.05). Conclusion Arterified venous flaps are more effective than island flaps in repairing fingertip soft tissue defect of hand trauma with high aesthetic value and good recovery of finger function.
Objective To compare the curative effect of arterialized venous flaps and island skin flaps in repairing soft tissue defect of fingertip caused by open hand trauma. Methods 88 patients with open hand trauma to fingertip soft tissue deficiency admitted to our hospital from November 2016 to November 2018 were selected as the objective of this study. The patients were divided into treatment group and control group by random lottery. Patients in the control group were repaired with finger island skin flaps, while those in the treatment group were repaired with miniature arterialized venous flaps. Discuss the difference in the incidence of complications between the two groups. Results The flaps survived in both groups. The complication rate in the experimental group was 9.09%. The excellent rate of joint movement was 88.64%. The excellent rate of sensory recovery of injured fingers was 93.18%. The excellent rate of skin color was 97.37%. The patients' satisfaction with treatment was 95.45%. The indexes were better than those in the control group. The difference was statistically significant(P < 0.05). Conclusion Arterified venous flaps are more effective than island flaps in repairing fingertip soft tissue defect of hand trauma with high aesthetic value and good recovery of finger function.
引文
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[12]K.Opara,I.Nwagbara.Reconstruction of complex soft-tissue defects around the knee using the proximally based sural Island fasciocutaneous flap[J].Nigerian Journal of Clinical Practice,2018,21(6):726-730.DOI:10.4103/njcp.njcp_174_17.
[13]余少校,张振伟,杨诚,等.改良指背筋膜蒂逆行岛状皮瓣修复指端皮肤缺损[J].实用手外科杂志,2013,27(3):331-334.DOI:10.3969/j.issn.1671-2722.2013.03.009.
[14]刘军.改良指背筋膜蒂岛状皮瓣治疗指端皮肤缺损的临床疗效分析[J].创伤外科杂志,2019,21(3):228-229.DOI:10.3969/j.issn.1009-4237.2019.03.018.
[15]钱俊,芮永军,糜菁熠,等.手指侧方远端岛状皮瓣修复指端缺损[J].中华手外科杂志,2018,34(4):257-258.DOI:10.3760/cma.j.issn.1005-054X.2018.04.006.
[2]刘尊武,刘立南,周超,等.指背逆行筋膜蒂皮瓣修复指端缺损术后发生血管危象分析及治疗[J].中国处方药,2018,16(12):140-141.DOI:10.3969/j.issn.1671-945X.2018.12.093.
[3]黄辉强,郑晓东,张敬良,等.微型动脉化静脉皮瓣修复50例指端皮肤缺损[J].中华显微外科杂志,2016,39(2):188-191.DOI:10.3760/cma.j.issn.1001-2036.2016.02.027.
[4]杨锦,杨晓东,丁建波,等.游离足底内侧动脉化静脉皮瓣修复指端缺损[J].中华显微外科杂志,2013,36(2):188-189.DOI:10.3760/cma.j.issn.1001-2036.2013.02.031.
[5]叶铁良.腕掌侧静脉动脉化皮瓣在皮肤缺损型断指再植修复中的疗效分析[J].婚育与健康·实用诊疗,2014,(8):42-42,43.DOI:10.3969/j.issn.1006-9488.2014.08.035.
[6]侯海鑫,杨帆,侯海琴,等.指动脉顺行推进岛状皮瓣修复小儿指端皮肤缺损[J].中华手外科杂志,2018,34(5):393-394.DOI:10.3760/cma.j.issn.1005-054X.2018.05.027.
[7]余少校,张振伟,廖坚文,等.静脉动脉化指背筋膜蒂逆行岛状皮瓣修复手指组织缺损[J].中华显微外科杂志,2010,33(4):325-326.DOI:10.3760/cma.j.issn.1001-2036.2010.04.025.
[8]肖水军,孙萍,张立.手指侧方皮支血管链皮瓣与指动脉岛状皮瓣修复指端缺损的疗效[J].深圳中西医结合杂志,2018,28(17):133-135.DOI:10.16458/j.cnki.1007-0893.2018.17.067.
[9]Sukato Daniel C.,TimashpolskyAlisa,FerzliGeorge,et al.Systematic Review of Supraclavicular Artery Island Flap vs Free Flap in Head and Neck Reconstruction[J].Otolaryngology-Head and Neck Surgery,2019,160(2):215-222.DOI:10.1177/0194599818803603.
[10]谭权昌,闫浩,周胜,等.改良岛状筋膜蒂皮瓣重建指端缺损的临床疗效观察[J].中华手外科杂志,2018,34(4):314-315.DOI:10.3760/cma.j.issn.1005-054X.2018.04.028.
[11]Christopher M.Stewart,Jonathan H.Norris.Reconstruction of extensive medial canthal defects using a single V-Y,island pedicle flap[J].Orbit,2018,37(5):331-334.DOI:10.1080/01676830.2017.1423344.
[12]K.Opara,I.Nwagbara.Reconstruction of complex soft-tissue defects around the knee using the proximally based sural Island fasciocutaneous flap[J].Nigerian Journal of Clinical Practice,2018,21(6):726-730.DOI:10.4103/njcp.njcp_174_17.
[13]余少校,张振伟,杨诚,等.改良指背筋膜蒂逆行岛状皮瓣修复指端皮肤缺损[J].实用手外科杂志,2013,27(3):331-334.DOI:10.3969/j.issn.1671-2722.2013.03.009.
[14]刘军.改良指背筋膜蒂岛状皮瓣治疗指端皮肤缺损的临床疗效分析[J].创伤外科杂志,2019,21(3):228-229.DOI:10.3969/j.issn.1009-4237.2019.03.018.
[15]钱俊,芮永军,糜菁熠,等.手指侧方远端岛状皮瓣修复指端缺损[J].中华手外科杂志,2018,34(4):257-258.DOI:10.3760/cma.j.issn.1005-054X.2018.04.006.